鞍区孤立性纤维性肿瘤临床病理观察

Clinical and pathological analyses of saddle spindle cell tumors

目的探讨鞍区孤立性纤维性肿瘤的临床病理学特点及诊断要点。方法对1例鞍区孤立性纤维性肿瘤进行临床资料、影像学、病理形态学观察及免疫组化检测,并结合文献对其诊断及鉴别诊断进行探讨。结果患者女性43岁。MIR提示鞍区占位,肿瘤向鞍上及海绵窦侵犯。镜下可见梭形细胞结构,局部细胞密度较高,可见红染无细胞区及退变,核分裂平均<2个/10HPF,细胞呈编织状排列。免疫组化:CD34、CD99、bcl-2和vimentin(+),S-100和EMA(-)。结论发生于鞍区的孤立性纤维性肿瘤罕见。由于其发病部位特殊,需将临床资料、影像学资料与病理学及免疫组化特点相结合进行诊断,并注意与垂体细胞瘤、神经鞘瘤等鉴别。

Objective To explore the clinical and pathological features and main diagnostic points of saddle solitary fibrous tumors. Methods The clinical data, radiological, pathological and immunohistochemical features were analyzed in one case of saddle solitary fibrous tumors, and its diagnosis and differential diagnosis were explored with review of the recent literature. Results The patient was a 43-year-old female. Microscopically, the tumor showed that whorl-like spindle-shaped cell structure with locally high cell density, red-stained cell-free zone and degeneration. Less than 2 mitotic figures were seen per 10 HPFs. MIR showed the tumor located in saddle holder with infiltration into cavernous sinus. Immunohistochemical staining showed that the tumor was positive for CD34, CD99, Bcl-2, and vimentin, but negative for S-100 and EMA. Conclusion Solitary fibrous tumors are rarely found in saddle area. As for this special location, its diagnosis should be combined with clinical and radiologic data, pathological features and immunohistochemical findings, with differential diagnosis from pituitary tumors and schwannoma.